The term “gum disease” sounds serious, and it is. Advanced stages cause bone and tooth loss, which affect your ability to eat, speak clearly, and socialize. And even early stages of gum disease are risky, increasing the chance of developing heart problems, Alzheimer’s disease, and other chronic conditions. Fortunately, simple steps can reverse and prevent the early stage of gum disease, which is called gingivitis.

What is gingivitis?

When you have gingivitis, the tissue at the base of your teeth, called gingival tissue, becomes inflamed or swollen. The most common form of gingivitis happens when food particles and other substances build up around your teeth, causing sticky plaque and hard tartar to form at and below your gums.

“In the early stage, this buildup isn’t harmful if home care and regular dental cleanings can keep the inflammation in check,” explains Dr. Tien Jiang, an assistant professor in oral health policy and epidemiology at the Harvard School of Dental Medicine.

However, ongoing inflammation from gingivitis, especially as it travels below the gum line, can lead to an irreversible form of gum disease called periodontitis, which can damage the tissues and bones that support your teeth. (Dental X-rays may be needed to see if the inflammation from gum disease has become periodontitis.)

In addition, studies have shown that having gum disease can put you at higher risk for heart attack, stroke, and dementia.

Causes and symptoms

Certain risk factors increase your chances of getting gingivitis, including:

If gingivitis develops, you might not even know it; initially, gingivitis is usually painless. As it progresses, gingivitis symptoms can include:

Treating gingivitis

Regular cleanings from a dentist or dental hygienist can remove plaque deposits before gingivitis causes more serious problems. The dental team has special tools that can scrape under the gumline.

If your gums are sensitive after cleanings, Jiang suggests rinsing your mouth with warm water mixed with table salt twice a day, taking acetaminophen or ibuprofen (as long as your medical conditions permit taking these pain relievers), or both. “If the gingivitis was extensive, you may need to allow up to two weeks for the tissues in your mouth to recover,” she adds.

You can ask your dentist to go over toothbrushing techniques with you, as well as whether you could benefit from an electric toothbrush, a special toothpick, or a water flosser.

Reversing and preventing gingivitis at home

Brushing teeth at least twice a day, and flossing at least once a day, can help reverse and prevent gingivitis. Jiang recommends brushing in front of a mirror in a bathroom with good lighting. She suggests pulling back your lips to look in a mirror for plaque at the gumline, or feeling with your tongue after brushing to search for rough areas of plaque. If you spot remaining plaque, angle your toothbrush to better reach those areas. If you repeatedly miss certain areas, try replacing your toothbrush head. Often, a smaller toothbrush head can do a better job getting to hard-to-reach areas.

Your dentist also may recommend anti-plaque or anti-tartar toothpastes or mouth rinses.

Identifying hot spots

Not sure if you’re brushing adequately? This might be a concern if you’ve lost hand dexterity, and wielding a toothbrush is tough. But give yourself some credit. “Most people do a good job removing plaque from the smooth or chewing surfaces of their teeth,” Jiang says, “but you need to pay attention to other places where plaque sticks, such as the gumline or between teeth, in order to avoid gingivitis.”

She says you might consider using over-the-counter plaque rinses or tablets that stick to plaque and turn it a bright color. That will help you identify areas where plaque is building up and where toothbrushing is especially needed.

(Reviewed by Tien Jiang, DMD, MEd, contributor and editorial advisory board member for Harvard Health Publishing)

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